1. What is it?
Dyshidrotic eczema is a form of eczema which affects the hands and the feet, but is more common on the hands. It tends to affect young adults and older people. Most people, who develop this form of eczema, have a history of allergy.
2. What does Dyshidrotic eczema look like?
In the early stages, this form of eczema appears as small fluid filled vesicles, along the sides of the fingers, palms of the hands, or the bottom of the feet. The vesicles may rupture forming weeping crusts that can sometimes take up to a few weeks to heal. As the vesicles heal they may leave rings demarcating where the vesicles had been. Generally the skin beneath the vesicles is not damaged.
Bacterial infection of open vesicles is a common complication. This may spread in the tissues to become cellulitis, an infection of the soft tissues of the hands or feet. The infection may also spread to neighbouring lymph nodes. Rarely the infection may spread to the blood causing septicaemia (generalised bacterial infection), which is life threatening. The nails may also be affected; they may become thick, pitted, discoloured and ridged.
3. The Dyshidrotic eczema myth
This form of eczema got its name because it was thought that it was caused by excessive sweating of the hands. It is now know that the fluid which accumulates in the vesicles is not sweat, but serum. It if felt the serum accumulated between the outer layers of the skin when the skin becomes irritated.
4. What causes Dyshidrotic eczema?
Researchers are not certain as to why people develop Dyshidrotic eczema. However, a number of things have been noticed to be associated with its development. There is a seasonal pattern to its occurrence, with it being more common in warm weather. Some persons develop Dyshidrotic eczema after being exposed to very sunny weather.
The condition is, more common in people who have a history of contact irritant dermatitis. It is especially associated with certain professions. People who have to regularly wash their hands, such as cooks, nurses and dentist, tend to get this type of hand eczema more commonly. Dyshidrotic eczema is aggravated by irritants such as solvents, detergent and soap.
5. How to treat Dyshidrotic eczema.
The best approach is to find out what irritant is contributing to its development and avoid its use. Other wise treatment is symptomatic. Your doctor may prescribe oral anti-itch medication for the intense itching which normally accompanies this condition. Applications such as dilute potassium permanganate or aluminium acetate can be used to help dry up the blisters. Steroid ointments may also be used in the acute stages to help to clear up the condition. In severe cases oral steroids may be used for a short time.
It is also important to keep the skin well moisturized, to prevent dryness and painful cracking which sometimes occurs with Dyshidrotic eczema. It is best to use a thick moisturiser such as emollient or Vaseline.